Could intense exercise burn off Botox injections along with calories?
Smooth-faced citizens are wondering if neurotoxins like Botox — which are used to reduce wrinkles at med-spas nationwide — lose their anti-aging power during bouts of extreme exercise.
Botox only lasts around three months. And with average smoothing sessions costing about $440 each — or about $1,500 per year — clients are concerned with protecting their investment, even if they can’t furrow their brows to show it.
So, how real is the threat of “losing” your Botox with too many Pilates sessions?
Dr. Claudia Kim, a board-certified cosmetic surgeon and the Chief Medical Officer of cosmetic surgical company New Look New Life, said it’s not too likely — even if you’re at SoulCycle three times a week.
But highly active individuals — like those in the final stretches of training for a marathon and running six times a week— may notice results fading on the earlier side.
One small study found that people with moderate to high activity levels began showing more muscle recovery around the two-month mark compared with less-active participants. But even that evidence is still limited.
“I would never tell a patient to stop exercising just to make their Botox last longer,” Kim told The Post. “Exercise is good for you. If someone is very active and consistently notices that their Botox wears off sooner, that’s something we can take into account when we tailor their treatment.”
Kim advises patients to avoid anything that significantly increases body heat, sweating, pressure, or irritation around the area—including intense workouts, hot yoga, saunas, and hot tubs — for the first day or two after treatment, because that’s when the neurotoxin is absorbed fastest by the body.
The primary reason you can’t hit a Hyrox session right after a face treatment is that the product might spread into unintended muscles — not melt or sweat out of your body.
“You do not need to go home and sit perfectly still after Botox,” said Kim, noting that patients often confuse standard 24-hour aftercare recommendations with permanent restrictions.
Other doctors consulted by The Post agree.
“I haven’t seen a consistent relationship between how much someone exercises and how quickly their Botox wears off,” said Dr. Henry D. Sandel of the Sandel Duggal Plastic Surgery and Medical Spa. Sandel “would be cautious about telling patients their workouts are shortening their results.”
Dr. Ava Shamban, Founder at AVA MD Dermatology, agreed that exercise is only one piece of the puzzle — she also says the longevity of the anti-aging treatment rests on the provider’s technique, the specific product used, the number of units administered, the injection placement and even a person’s resting metabolic rate.
Botox remains the world’s most popular cosmetic enhancement procedure, according to the International Society of Plastic Surgery, which estimates that 7.8 million treatments happened in 2025 — half in the US alone.
